Treatment for tongue carcinoma by interstitial radiotherapy simultaneously combined with continuous chemotherapy

为提高舌癌原发灶的局部控制率和预防转移，采用持续注射培洛霉素同时进行组织间放疗的方法治疗舌癌原发灶。本研究纳入39例新鲜舌鳞状细胞癌病例，其中8例为试验组，其余为对照组。治疗组在放疗期间连续给予培洛霉素10- 15 mg，每日2- 3 mg。放疗前静脉注射培洛霉素5 mg。两组的放射剂量均为每48-144小时约60戈伊。两组的局部控制率和治疗结束后至少3个月的生存率几乎相同。试验组仅1例T2患者首次登记时存在颈淋巴结转移。治疗后4 ~ 6个月，试验组和对照组分别有1例和2例出现局部淋巴结转移。5例均行根治性颈淋巴结清扫术。所有病例均无远处转移。至于治疗期间和治疗后的粘膜反应过程，试验组的黄色斑块完全消失倾向于延迟。由于病例数和观察时间有限，迄今为止，两组之间没有发现显著差异。局部控制率和转移率有待于长期随访。

For the improvement of local control rate and the prevention of metastasis a continuous injection of Peplomycin simultaneously combined with interstitial radiotherapy was applied for the treatment of the primary lesion of tongue carcinoma. Thirty-nine fresh cases of squamous cell carcinomas of the tongue were put into this study, 8 of them were in the trial group and the others were the control. For the trial group total 10-15mg of Peplomycin were administered continuously during the period of the interstitial radiotherapy with the rate of 2-3mg per day. Prior to the inters titial radiotherapy another 5mg of Peplomycin were given intravenously. The dose of radiation was approximately 60 Gy per 48-144 hours in both groups. The local control rate and the survival rate at least 3 months after the completion of the treatment were almost the same in both groups. Only a case of T2 in the trial group was of cervical lymphnode metastasis at the first registration. The metastases to the regional lymphnode were found in total 3 cases, 1 in the trial group and 2 in the control group during 4 to 6 months after the treatment. Radical neck dissection was performed in all 5 cases. No distant metastasis was found in all cases. As to the course of mucosal reaction during and after the treatment, a complete disappearance of yellow plaque tended to delay in the trial group. Because of the limited case number and observation period there found no remerkable difference between 2 groups up to date. The positive resalts in the local control rate and the incidence of metastasis will be expected by continuing long term follow-up.